Grobbee DE, Burger H, Hofman A, Pols HA
Blood pressure and bone density are inversely related in the elderly
16th Scientific Meeting of the International Society of Hypertension
ISH Abstract Book (Jun) 16: 1996

Changes in calcium metabolism have been demonstrated in primary hypertension. Renal calcium loss, potentially in relation to a high sodium intake, with secondarily enhanced parathyroid gland activity has been proposed as one of the mechanism to be involved. In the long run, such a mechanism could lead to a reduced bone mineral content (BMC). This study examined blood pressure and BMC in a very large number of elderly men and women (5636 subjects aged 55 years and over) enrolled in the Rotterdam Study. BMC was measured using a Lunar DPX-L densitometer.

An increase of 1 g in BMC at the femoral neck was associated with a fall in diastolic blood pressure of 0.36 mmHg (95% Confidence Interval 0.01, 0.72: adjusted for age, sex, weight, height, antihypertensive drug use). Among those not using antihypertensive drugs the fall was 0.70 mmHg (95% CI 0.27, 1.09). Associations were similar for BMC at the trochanter and Wards' Triangle but slightly less pronounced in women than in men. No consistent associations were observed for systolic blood pressure.

Comment: Diastolic blood pressure is lower when bone density is higher in elderly subjects. This may reflect chronically impaired calcium status in subjects with elevated blood pressure, and supports the view that disturbances in calcium metabolism, possibly involving the kidney, are implicated in primary hypertension (Carmine Zoccali, M.D, Reggio Calabria, Italy).

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16th Scientific Meeting of the International Society of Hypertension
H: Special problems : Hypercalciuria
H: Special problems : Elderly